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On July 25, 1978, the birth of Louise Joy Brown made her parents extremely elated. They were over the moon to hold their baby girl in their arms, but they weren’t the only ones celebrating. Robert G. Edwards and Patrick Steptoe also rejoiced, as their technique had proved successful, and the world got its very first test tube baby!
Before we get into the details of a test tube baby, we should first understand how a normal baby is produced. A woman has 3 basic parts of her reproductive system – the ovaries, the fallopian tubes, and the uterus. The ovaries produce the eggs, which mature once a month. Usually, both of the ovaries release an egg every other month, thus regulating the release of eggs to one per month.
The released egg is picked up by the fimbriae of the fallopian tube (the diagram makes this easier to understand!). It then moves through the fallopian tube and into the uterus. The fertilization between the egg and the sperm must take place while the egg is passing through the fallopian tube. The fertilized cell, now called the zygote, enters the uterus and attaches to the uterine wall. This is known as implantation. Once implantation has occurred, a woman is considered pregnant.
In vitro fertilization is a technique that aids in reproduction. It falls under the category of ART – Assisted Reproductive Technology. These techniques are used in cases where reproduction cannot occur normally. IVF involves the fertilizing of an egg and sperm outside the body. It requires a combination of medication and minor surgical procedures, and can have great results. In IVF, the sperm, egg or both could come from a donor.
There are 4-5 steps involved in the whole process. First, the woman is put on medication that suppresses her hormones. Since the menstrual cycle is largely determined by hormones, this step ensures that the doctor has complete control of the cycle.
Once the cycle is under the doctor’s control, medications are given to the woman to induce the release of multiple eggs from the ovaries. If you remember, this is not a normal part of the menstrual cycle. Under natural conditions, the body usually releases just one egg a month. The medications that are given induce the maturation and release of multiple eggs at the same time.
The doctor then collects the eggs by inserting a thin, hollow needle into the pelvic region. The needle is connected to a suction pump that draws out the eggs. This is a minor surgical procedure, during which medication is given to reduce or eliminate any sort of discomfort.
The collected eggs are then mixed with the donor sperm in a petri dish and fertilization is allowed to occur. If the sperms have low motility, they can be injected into the egg to spur the formation of the zygote.
The zygote starts dividing and is now referred to as an embryo. Roughly 3-5 days after the retrieval of the eggs, these embryos are transferred into the uterus of the woman. Typically, implantation of the embryo will occur in about a week’s time, and the woman attains the state of pregnancy.
While there may be some side effects, such as nausea, bloating, slight discharge etc., most women can usually go back to their daily lives within a day or two.
When is IVF used?
IVF is a technique that is used in a number of infertility cases. These include:
- Low sperm count, or low sperm motility
- Damage to the fallopian tubes
- In the case of a tubectomy. Tubectomy is a method of permanent contraception in females. The fallopian tubes of the female are cut at an interval and tied to prevent fertilization from taking place.
- Women with ovulation problems
- Men with deformed sperm
These are some of the cases when IVF can be used. In a nutshell, it can be used as an option in the case of infertility once other treatments and options have failed.
Risks of IVF
Although it is considered relatively safe, IVF still poses some amount of risk. If there is heavy vaginal bleeding, sudden weight gain, dizziness etc., it could be indicative of something being wrong.
During the retrieval of eggs and the transfer of embryos, there could be damage to the cervix, vagina, uterine wall, etc.
It is not necessary for only one embryo to be transferred at a time. To increase the chances of pregnancy, a couple of them could be transferred, as it isn’t necessary that every transplanted embryo gets implanted. However, the transfer of multiple embryos also carries the risk of multiple pregnancies. Such babies are usually born underweight and prematurely.
IVF may also increase the risk of an ectopic pregnancy. When the embryo implants somewhere outside the uterus, it is known as an ectopic pregnancy. This implantation usually occurs in the fallopian tubes. The fetus cannot survive such an occurrence, and it may also prove life-threatening to the mother.
Another risk factor associated with IVF is OHSS – Ovarian Hyperstimulation Syndrome. This is an adverse reaction to the fertility medications, which can cause swelling of the ovaries. OHSS is a painful and dangerous condition.
While the option of carrying out IVF without fertility medication exists, it doesn’t have as high a success rate. The chances of success also drop with the increase in age of the mother, particularly above the age of 30-35.
However, that being said, IVF is a major boon. It has nursed and fulfilled the dreams of millions of people to have their own children. My only issue is that Louise Brown should be called a petri dish baby, rather than a test tube baby. After all, that’s where the fertilization took place!
- Human Fertilisation And Embryology Authority
- American Pregnancy Association
- Planned Parenthood